Laser therapeutic device

ABSTRACT

Laser therapeutic apparatus irradiates an area of cutaneous and/or subcutaneous physical injury, with a pulsed laser wave, producing healing and pain reduction. A pulsed laser beam of desired frequency is produced by reducing the output of an oscillator via a frequency multiplier which is varied in accordance with the off-nominal frequency deviation desired, if any. The rate multiplier output wave is divided down to a selected frequency and, after amplification, generates pulsed lasing energy. 
     In accordance with varying aspects of the instant invention, a plurality of output lasing units, and optical diffusing lenses, are provided for controlled irradiation of an entire injured area. Circuitry is also provided for detecting pulsed infrared light.

This application is a continuation of application Ser. No. 586,560,filed Mar. 6, 1984, now abandoned.

BACKGROUND OF THE INVENTION

The present invention relates generally to laser therapeutic devicesused to promote healing and reduce pain in injured mammalian tissue and,more particularly, to an improved laser therapeutic device whoseperformance is enhanced and its ease of operation improved.

In this regard it is important to distinguish between the more commonlyknown cutting or burning laser used in surgery and therapeutic laserswhich promote the healing of injured tissue. In recent years, lasertherapeutic devices have come into use to promote the healing of injuredtissue, and to reduce pain and edema. Such devices generally use a lowpower infrared laser in the form of an LED. These devices have been usedmore often with the treatment of equine injuries. More recently,experimentation has begun with the use of such lasers to treat humaninjuries. The precise biological mechanism by which these devicesoperate is unknown. For example, it is not known whether it is theintensity of the photic energy, the rise or fall time of the pulse, orwhether it is some other characteristic of the beam. Clinical studiesare now under way to gain a better understanding of the biologicalmechanism.

Laser therapeutic devices generally utilize a separate power supply anda remote probe containing the laser LED. In operation, the user turns onthe power, selects a pulse rate in accordance with the particular injuryto be treated and thereafter, manually scans the laser beam across theinjured tissue for a predetermined period of time. However, such devicesare prone to problems because the laser beam must be manually scannedacross the injured area. Such manual scanning may result in aninconsistent distribution of laser energy into the wound area.Furthermore, since the device must be manually scanned, the operator isthus required to stand over the patient and manipulate the probe forlong periods of time. More recently, in an attempt to avoid the scanningdifficulties lasers having a multiplicity of LED's have been proposed.However, these devices simply provide a number of pinpoints rather thanuniform energy distribution and cause power supply problems.

SUMMARY OF THE INVENTION

The present invention is directed to a laser therapeutic apparatus whichirradiates an area of cutaneous and/or subcutaneous physical injury,with a pulsed laser wave, producing healing and pain reduction. A pulsedlaser beam of desired frequency is produced by reducing the output of anoscillator via a frequency multiplier which is varied in accordance withthe off-nominal frequency deviation desired, if any. The rate multiplieroutput wave is divided down to a selected frequency and, afteramplification, generates pulsed lasing energy.

In accordance with varying aspects of the instant invention, a pluralityof output lasing units, and optical diffusing lenses, are provided forcontrolled irradiation of an entire injured area. Circuitry is alsoprovided for detecting pulsed infrared light and providing a visualindication thereof.

It is accordingly an object of this invention to provide an improvedlaser therapeutic device.

It is another object of this invention to provide an improved lasertherapeutic device which provides laser energy over a wide area withoutthe need for mechanical scanning.

It is another object of this invention to provide an improved circuitryfor a laser therapeutic device.

It is another object of this invention to provide a detector means forinfrared pulsed laser energy.

It is another object of this invention to provide an improved lasertherapeutic device suitable for treatment of all types of mammaliantissue.

It is another object of this invention to provide an improved lasertherapeutic device that may be used by operators of all proficiencylevels without the risk of injuring the patient.

It is another object of this invention to provide an improved lasertherapeutic device that is particularly suitable for human application.

To these ends, the present invention provides an improved therapeuticlaser including means for distributing the laser radiation over a widearea to be treated. The device uses a gallium aluminum arsenide diode asa source of laser energy in the infrared band, at a wavelength ofapproximately 900 nanometers. Digital circuitry provides the pulse trainto activate the diode. Circuitry for detecting pulsed infrared energy isalso provided.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other features and advantages of the present inventionwill become more clear from the following detailed description of aspecific illustrative embodiment thereof presented hereinbelow inconjunction with the accompanying drawing, in which:

FIG. 1 is a block diagram of electronic apparatus in accordance with theinstant invention for producing a therapeutic pulsed laser beam via oneor more lasing diodes 40_(i) ;

FIG. 2 is a schematic diagram depicting indicator apparatus selectivelyresponsive to incident pulsed laser energy for providing a constantvisible light spectrum "active state" indication via a light emittingdiode 68; and

*FIGS. 3 through 5 depict mechanical implementations for the electronicapparatus of FIGS. 1 and 2 which employ plural operative lasing diodes40_(i).

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring to FIG. 1, there is shown pulsed laser generating apparatuswhich includes an electronic, mechanical, or electromechanical timer 12for operatively connecting DC potential from a source 10 thereof to thecircuitry of the instant invention for a period corresponding to thedesired therapeutic period for which pulsed lasing is required. Anoscillator 15, enabled during the active period of timer 12 (as is theremaining electronics of FIG. 1) supplies its output wave ofperiodically recurring pulses to the count input of a rate multiplier16. Also supplied as inputs to the rate multiplier 16 is a two digitBoolean rate multiplication control variable reposing in frequencydeviation register 17.

The stored contents of register 17 operate to vary the output frequencyof the rate multiplier 16 in the manner per se well known for digitalrate multiplication. Register 17 may comprise an electronic register asshown or, alternatively, an n position mechanical switch for supplyingcontrol inputs to rate multiplier 16 dependent upon manual switchsetting. As is per se well known, the output frequency_(fout) from ratemultiplier 16 equals

    f.sub.out =k·f.sub.in ·D                 (1)

where k is a proportionality constant typically less than 1, f_(in) isthe frequency received from the oscillator 15, and "D" is the ratescaling control variable from register 17. For present therapeuticpurposes, it is the function of the rate multiplier 16 to either pass adesired nominal frequency, or to increase or decrease the selectednominal frequency by approximately ±20% depending upon the contents ofregister 17.

The output frequency of oscillator and rate multiplier 16, possiblydeviated by the contents of register 17, are supplied to a binarycounter 20 having outputs from plural divider stages supplied as inputsto a selector switch 22. One of the output stages selected by switch 22is regenerated, i.e. squared in shape, by a Schmitt trigger 23, theoutput of which is supplied to an edge trigger circuit and frequencydoubler circuit 25.

In circuit 25, the regenerated rectangular wave output of Schmitttrigger 23 passes directly to the upper input port of an exclusive ORgate 26 while the same wave is delayed slightly in an integrator 27(e.g., a series resistor 28 and shunt capacitor 30) before beingsupplied to a lower input of the exclusive OR gate 26. It will berecalled that the output of an exclusive OR gate assumes its binary "1",high output level when and only when one and only one of its inputs ishigh. Accordingly, for each output pulse from Schmitt trigger 23, theoutput of exclusive OR gate 26 goes high and provides a first pulseduring the leading edge of the output of Schmitt trigger 23 when theupper input to gate 26 is a "1" but the lower input is a "0" because ofthe delay engendered by integrator 27; and generates a second output atthe trailing edge of the Schmitt trigger output when the upper gate 26input immediately goes low, whereas the lower input persists at the highor binary "1" level until capacitor 30 can discharge to the binary "0"state. Accordingly, the output of circuit 25 is at twice the frequencyas the input supplied thereto.

For purposes of the instant invention, we have found that each of theoutput lasers 40_(i) should pulse at frequencies of 76, 152 or 304pulses per second (nominal with possible plus or minus 20% adjustments).These frequencies bear a 2:1 and 4:1 relation with one another, and thusmay utilize three consecutive cascaded outputs of the counter 20.Oscillator 15 then runs at a frequency higher than 152 hz (304 hzdivided by two for the frequency doubling of circuit 25 decreased by theproportionality "k" factor of rate multiplier 16).

The output pulses from frequency doubler 25 are amplified in amplifier32 and supplied to one or more output stages 30_(i). One such stage30_(i) is shown in detail and is representative of the other such stagesemployed. Each output stage 30_(i) includes a field effect transistorswitch 33_(i) having a high voltage source 34 connected by the FET33_(i) drain-source path to ground via a resistor 35_(i). During thedormant period when the diode laser 40_(i) is off (corresponding to alow output potential from the exclusive OR gate 26 and amplifier 32),high voltage from the source 34 charges a capacitor 36_(i) via a pathcomprising the resistor 35_(i) and a diode 39_(i). During each pulseperiod when the output of the gate 26 goes high, amplifier 32 activatesthe FET switch 33_(i) causing the energy previously stored in thecharged capacitor 36_(i) to discharge via the FET drain-source paththrough the laser diode 40_(i). Accordingly, a pulse of laser energy isemitted for the duration of each output pulse from the exclusive OR gate26. The lasers 40_(i) in each other output stage 30_(i), if any,similarly emit energy each time the output of exclusive OR gate 26attains its binary "1" state. A suitable diode 40_(i) is a galliumaluminum arsenide diode operating in the infrared spectrum atapproximately 900 nanometers. The pulsed laser output energy operates asabove noted to provide its salutary cutaneous and sub-cutaneous healingand pain reducing benefits.

In accordance with one aspect of the instant invention, it is desirableto provide users with a continuous indication within the visible lightspectrum to indicate when the output lasers are active. A continuousvisible indication is needed because (i) the pulsed energy may be toorapid or too short to be discerned, (ii) the laser devices 40_(i)selected may not emit energy in the visible spectrum, and (iii) where awide angle dispersion of the beam is provided the energy per unit areais low and thus difficult to detect by conventional means. Thedetector/active state indicating circuitry of FIG. 2 basically comprisesan AC input stage coupled inverting mode operational amplifier 50coupled via an amplitude signal demodulating detector diode 60 andresistor-capacitor time constant circuit 62-63 to a non-invertingamplifier 66. Connected to the output of the non-inverting amplifier 66is a visible light spectrum emitting diode (LED) 68 which is illuminatedwhen the FIG. 2 apparatus detects pulsed output light from one or morelasers 40_(i). Also connected to the output of non-inverting amplifier66 via a scaling network 69-70 is a microammeter 72 which provides anindication of the amplitude or strength of the detected pulsed lasersignal.

In the absence of any incident pulsed laser energy, the output of theinverting amplifier 50 attains a low output level responsive to theabsence of input drive via capacitor 54. Thus little or no input issupplied to the non-inverting amplifier 66. When this conditionpersists, the corresponding low output of the non-inverting operationalamplifier 66 does not energize, i.e., does not turn on light emittingdiode 68 and does not supply a meaningful signal via microammeter 72.

In the presence of pulsed energy, the incoming laser pulses alternatelyturn a laser spectrum responsive transducer (e.g., a photocell orsilicon photodiode) on and off. With the diode on, a capacitor 56charges through resistor 58. The ensuing change in potential acrosscapacitor 56 as the transducer 55 alternately is rendered conductive andnon-conductive is coupled by capacitor 54 to the inverting inputterminal of the operational amplifier 52. The operational amplifier 52operates in an inverting mode such that its output produces large,inverted replicas of the incident laser energy pulses. As is per se wellknown, the sensitivity of amplifier 52 is adjusted via the setting of apotentiometer 76.

In the presence of the pulsed laser energy, the voltage at the output ofthe operational amplifier 52 is detected via the diode 60 and the shuntresistor capacitor 63 and 62 which operate as a peak detector or outputsignal demodulator. The resulting positive signal persisting acrosscapacitor 62 is supplied to the non-inverting input of the operationalamplifier 66 which thus provides a direct current output potentialproportional to the peak detected potential reposing across capacitor 62and resistor 63 with a gain determined by the ratio of resistors 67 and65. Thus, the output of operational amplifier 66 is high in the presenceof detected pulsed laser energy to activate the light emitting diode 68and the microammeter 72, and is low to disable these active stateindicators in the absence of any detected pulsed laser energy.

The circuitry of FIGS. 1 and 2 has thus been shown to generate therequisite pulsed laser energy with the frequency deviation controldesired; and to provide an output indication via LED 68 of an activestate for the laser while providing analog measure of the strength ofthe laser pulses at the microammeter 72.

In accordance with another aspect of the invention, FIG. 3 illustrates afirst embodiment of a head assembly for providing a uniform wide-angleenergy distribution of the radiant energy output of lasing diodes40_(i). FIG. 3a and 3b illustrate a wide angle head assembly 78 in whichtwo lasing diodes 40_(i) are mounted to X-shaped cross-braces 80 so thatthe head of each diode 40_(i) faces rearwardly and is aimed at concavecurved mirrors 82 which reflect the light back towards diodes 40 in awide arc. Mounted in front of diode 40_(i) is a light diffusing ordispersing lens element 84 to further uniformly distribute the infraredenergy. While known light diffusing elements such as ground or frostedglass may be used for lens element 84, a diffusion lens causes lightattenuation. Obviously, attenuation is not desirable. Thus, rather thana diffusion element, a light dispersion element utilizing clear glass orplastic having a microprismatic structure is preferable. Each of themicroprisms act to further reflect and refract the light and thusoptimizes energy distribution.

If a more compact head assembly is desired, FIG. 3c illustrates such anarrangement of a head assembly 85. Assembly 85 has the lasing diode40_(i) mounted vertically generally at the focal point of curvedreflector 82. Dispersing element 84 is disposed in front of diode 40_(i)and reflector 82 to provide further distribution of the radiant energy.In this arrangement diode 40_(i) emits light both toward reflector 82and forwardly to provide a wide angle blend of direct and reflectedenergy. This construction provides a compact arrangement of the headassembly and two assemblies may again be used in side by side array.

In these constructions each diode and reflector assembly providesuniform energy distribution over an area of approximately one inch byone inch or a total of two square inches for both diode assemblies. Thissize head has been found optimum for a wide variety of applications.Should a larger area be needed, additional diode assemblies may beadded.

FIG. 4 illustrates another embodiment of a wide angle laser headassembly utilizing a single flat mirror rather than two curved mirrors.In this embodiment, lasing diodes 40_(i) are angled rearwardly at eachside of a head assembly 86. Diodes 40_(i) are each aimed at a flatmirror surface 88. The laser light is then reflected back towards aforwardly mounted light dispersing element 90, similar to that describedabove with respect to FIG. 3. This arrangement has an advantage in thatthe laser diodes 40_(i) are not centrally located with respect todispersion element 90 and, thus, do not block the light at the center.It has been found that a suitable mounting angle for the laser diodes isat an angle of 20° from the perpendicular to dispersion element 90. Ofcourse, other suitable angles may be used, depending on the size andoverall dimensions of head assembly 86. Dispersion element 92 in thisconstruction is approximately one inch by two inches.

In certain types of treatment, a non-dispersed narrowly directed beam ofa single laser diode may be appropriate. Accordingly, a laser head whichprovides either a narrow angle beam or a wide angle beam is desirable.This may be accomplished by adding a separate switchable non-disperseddiode to any of the above described wide angle assemblies. However, inorder to reduce the cost of production of a dual angle head, it isdesirable that the same laser diode be used to provide either a wideangle or a concentrated beam. The head assembly 94 illustrated in FIGS.5a and 5b provides such an arrangement and further includes a mechanicalshutter for the diode which is required under certain governmentalregulations.

Head assembly 94 includes a slide switch 96 having three positions whichcorrespond to a wide angle beam, a narrow beam and a shuttered position.Lasing diode 40_(i) is mounted to a sliding carrier 98 which is moved bya manually operated toggle 100, as toggle 100 moves forward, lasingdiode 40_(i) will move forward. The forward portion of carrier 98includes a mirror deflector 101 which engages a spring loaded pivotingmirror 102. When toggle 100 is in its rearmost first position as shownin FIG. 5a, mirror deflector 101 will be located rearwardly with respectto mirror 102 and will thus permit it to assume an angle α. In thisposition, the light from diode 40_(i) will be reflected from mirror 102towards a dispersing lens element 104 similar to those previouslydescribed. In this position, mirror 102 and dispersing element 104 willprovide a wide angle uniform distribution of infrared radiant energy.

When the toggle 100 is moved all the way forward into its secondposition as shown in FIG. 5b, mirror deflector 101 will act to pivotmirror 102 downwardly out of the path of lasing diode 40_(i). Thus, theoutput of diode 40_(i) will not be reflected towards dispersion element104, but rather will impinge on a snout lens 106 which will provide arelatively narrow beam.

When toggle 100 is moved to a neutral position, between the first andsecond positions, the mirror will pivot to an angle between α and 0 andthe output of diode 40_(i) will impinge on neither dispersion element104 nor snout lens 106. Thus, the mirror acts as a mechanical shutter toblock the escape of radiant energy. Furthermore, in its neutralposition, toggle 100 is arranged to electrically disconnect diode 40_(i)by a switch 120 as shown in FIG. 5b so that both electrical andmechanical closure of the beam is provided.

The above-described arrangement is merely illustrative of the principlesof the present invention. Numerous modifications and adaptations thereofwill be readily apparent to those skilled in the art without departingfrom the spirit and scope of the present invention.

What is claimed is:
 1. A circuit for operating a laser therapeuticdevice comprising:a power source; an oscillator connected to said powersource for providing an output of a predetermined frequency; a ratemultiplier having a count input connected to the output of saidoscillator, said rate multiplier having a second input for receiving arate multiplication control variable and an output, the frequency of theoutput of said rate multiplier being a function of the ratemultiplication control variable received; a frequency deviation registercoupled to said second input of said rate multiplier, said registersupplying said rate multiplication control variable to control thefrequency output of said rate multiplier; a binary counter having aninput connected to the output of said rate multiplier and an output; aregenerating circuit having an input connected to the output of saidbinary counter and output means for providing a regenerated rectangularpulse train; and an output stage including an infrared laser diode, saidoutput stage having an input connected to the output of saidregenerating circuit to receive the pulse train generated by saidregenerating circuit to activate said diode upon the receipt of eachpulse.
 2. The circuit as claimed in claim 1, wherein said regeneratingcircuit comprises a Schmitt trigger.
 3. The circuit as claimed in claim1, wherein said binary counter includes multiple divider stages andmeans for selecting one of said multiple stages.
 4. The circuit asclaimed in claim 1, wherein said output stage includes an electronicswitch having a power input connected to a power source, a control inputand an output connected to said laser diode, the control input of saidelectronic switch receiving said pulse train from said regeneratingcircuit.
 5. The circuit as claimed in claim 4, wherein said electronicswitch comprises a field effect transistor.
 6. The circuit as claimed inclaim 1, further including a frequency doubling circuit disposed betweensaid regenerating circuit and said output stage.
 7. The circuit asclaimed in claim 6, wherein said frequency doubling circuit comprises anexclusive OR gate having a first input connected to said output of saidregenerating circuit and a second input connected to the output of saidregenerating circuit through an integrating circuit to delay in time thearrival of the pulse train to said second input and thereby double theoutput of said frequency doubler circuit.